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  1. FHIR Specification Feedback
  2. FHIR-28249

How to determine mCODE compliance

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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • US Minimal Common Oncology Data Elements (mCODE) (FHIR)
    • 1.0.0 [deprecated]
    • Clinical Interoperability Council
    • TNM Clinical Stage Group [deprecated]
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      We have added clear criteria for what is in scope of mCODE and what is not, including a definition of what patients are included in mCODE (those with cancer conditions or those explicitly declared by the server as in scope), and which resources associated with an mCODE patient are in scope. The new mCODE bundle (aka the mCODE $everything) also makes clear what MUST, SHOULD, and MAY be included. 

      We have confirmed with the Inferno team that the proposed criteria are computable and testable. 

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      We have added clear criteria for what is in scope of mCODE and what is not, including a definition of what patients are included in mCODE (those with cancer conditions or those explicitly declared by the server as in scope), and which resources associated with an mCODE patient are in scope. The new mCODE bundle (aka the mCODE $everything) also makes clear what MUST, SHOULD, and MAY be included.  We have confirmed with the Inferno team that the proposed criteria are computable and testable. 
    • Russ Leftwich / May Terry: 5-0-1
    • Enhancement
    • Non-compatible

    Description

      When testing compliance with mCODE, we might find resources that fail to comply to any mCODE profile. Does this mean that the system fails to comply with mCODE? 

      Presumably any EHR contains three types of resources:

      1. Resources that are explicitly in the scope of mCODE and therefore, if they fail validation testing, it implies non-compliance with mCODE. An example is an observation with code LOINC 21908-9, Clinical Stage Group.
      2. Resources that are clearly outside the scope of mCODE and are not expected to comply with mCODE profiles. An example is a VisionPrescription resource.
      3. Resources that may be connected to mCODE might be intended to be mCODE compliant. An example is a Condition resource that might be intended to be an mCODE ComorbidCondition, PrimaryCancerCondition, or SecondaryCancerCondition resource, or maybe not.

      Perhaps one option to disambiguate the third category is to have the server system declare whether an instance is intended to be mCODE compliant by including some declaration in the instance itself. This could be accomplished by putting the name of an mCODE profile in meta.profile. This is not currently required by mCODE. 

      I would like to see a thoughtful discussion of this problem and development of clear conformance criteria.

       

       

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            Mark_Kramer Mark Kramer
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